Evaluating social rehabilitation of aggression for persons with Acquired Brain Injury: a systematic review.

PURPOSE: Social rehabilitation of aggression following an Acquired Brain Injury (ABI) is critically important for persons with ABI due to increased vulnerability of criminal behaviour related to post-injury changes in functioning. This review presents findings from studies that evaluated aggression interventions in both community and forensic populations of people with ABI. METHODS: We searched PsycINFO, EMBASE, SocINDEX, CINAHL and Medline databases for studies published between 1st January 2000 and 15th October 2023. RESULTS: There were 15 studies (14 community-based, one forensic) that met inclusion criteria. Pharmacological management (6) was largely ineffective and anger management interventions (6) presented with inconsistent effectiveness. Emotion regulation (1) may be effective for externalised aggression. Both mindfulness and transcranial direct current stimulation (1) were effective, and the results of a forensic peer group approach (1) were not tested for statistical significance. There was variability in the measurement of aggression, injury severity, and cognitive impairment. CONCLUSIONS: Whilst community interventions for aggression in persons with ABI are prevalent, findings for effectiveness have been mixed and there is a paucity of evaluated interventions in forensic samples. Further research is needed to unravel the complex interplay of factors contributing to aggression and develop effective social rehabilitation for persons with ABI.

Social rehabilitation is critical following an Acquired Brain Injury (ABI) due to increased risk of displaying challenging behaviours, such as aggression, that may significantly reduce an individual's quality of life.The current review highlights a lack of suitable interventions targeting aggression for individuals with ABI that account for injury-related impairments which impact capacity to engage in intervention.Findings emphasise the need to develop appropriate and relevant social rehabilitation interventions for aggression in ABI populations, particularly forensic populations, to prevent negative outcomes.

Randomized effectiveness-implementation trial of dialectical behavior therapy interventions for young people with borderline personality disorder symptoms.

OBJECTIVES: Dialectical behavior therapy (DBT) is an evidence-based treatment for people with emerging borderline personality disorder (BPD). In "real world" clinical settings, standard DBT is resource intensive. Emerging evidence suggests that group-based DBT skills training alone can lead to promising outcomes. This hybrid type 1 effectiveness-implementation trial directly compared the effectiveness of an 8-week group DBT-skills training program and a 16-week DBT-informed program including individual treatment and group-based skills training. METHODS: This pragmatic trial employed a staggered, parallel-groups design. We recruited 104 participants, aged 16-25 years, with emotion dysregulation or emerging BPD symptoms. Participants were randomized to receive either program at a youth mental health service located in the Gold Coast, Australia. Data was collected via online surveys at baseline, 8-week, 16-week, and 24-week follow-up. Mixed effect linear models compared groups on the primary outcomes of emotion dysregulation and BPD symptoms, and secondary outcomes of suicidal ideation, coping skills, depression, anxiety, and stress. RESULTS: Across groups there were significant and sustained improvements relating to emotion dysregulation, BPD symptoms, stress, depression, and emotion-focused coping; but not suicide risk, anxiety, or task-focused coping. There was no significant time by group differences between the 8-week and 16-week interventions on any primary or secondary outcome. CONCLUSION: The more intensive mode of delivering DBT was not more effective than the brief group-based skills training. Both interventions resulted in significant improvements across both primary and most secondary outcomes. These results have implications for clinical practice regarding length and intensity of DBT treatment in young people.

Preventing Sexual Harm in Nightlife Settings: A Scoping Review.

Sexual harm within nightlife settings is a pervasive global concern; however, little is known about the nature of available interventions. The current study aims to review the literature on the nature and effectiveness of nightlife-related sexual harm interventions. A systematic literature search of six databases was conducted to identify records that were published between 1970 and June 2023 and reported approaches that aimed to reduce or prevent nightlife-related sexual harm. Records were included if they theorized, discussed, or evaluated an intervention, prevention or response strategy; however, individual safety strategies were excluded. Results were categorized according to intervention type. Thirty-five peer-reviewed journal articles and 16 gray literature records were identified. The most common nightlife-related sexual harm intervention strategies covered by the literature included targeted policies, laws, and regulations, bystander interventions, and awareness-raising campaigns. Literature in the area is increasing, with the majority of the articles (77.1%) being published in the previous six years; however, there are very few interventions that have been critically evaluated (22.9%). Promising areas for intervention include targeted alcohol regulations (e.g., lockout policies), venue-level policies, and environmental interventions. However, an increase in rigorous evaluative practices is urgently required to ensure future interventions are based on sound theoretical work and empirical evidence.

The risk of repeated suicidal presentations following residential treatment for substance use disorders: A recurrent event analysis using linked administrative data.

BACKGROUND: Individuals seeking alcohol and other drug (AOD) treatment consistently experience higher rates of suicidal behaviours and death by suicide when compared to the general population. By linking residential AOD treatment data to administrative healthcare and death datasets, we aimed to examine suicide-related behaviours and identify risk and protective factors for these events following discharge from residential treatment. METHODS: Participants included 1056 individuals aged 18-69 (M = 32.06, SD = 9.55, male = 696,65.9 %) admitted to three residential treatment facilities in Queensland, Australia from January 1, 2014 to December 31, 2016. Treatment data was linked to administrative hospital, emergency department (ED), mental health service, and Registry of Deaths data 2-years post-discharge. ICD-10 codes were used to identify and analyse suicide-related events. RESULTS: Within 2-years post-discharge, 175 (16.6 %) individuals had a suicide-related event (n = 298 episodes). The highest proportion of episodes (11.1 %) occurred within 1-month of discharge. Higher risk of a recurrent suicide-related event was associated with receiving a Disability Support Pension (aHR = 1.69 (95%CI:1.10,2.59), two or more previous episodes of residential AOD treatment (aHR = 1.49 (95%CI:1.30,2.15). Completing residential treatment was associated with a lower risk of suicide-related events (aHR = 0.54 (95%CI:0.35,0.83). LIMITATIONS: The amalgamation of suicidal ideation, attempts, and death into a single outcome oversimplifies their complex nature and interplay. The exclusive focus on one service provider limits generalisability, and data constraints and missingness preclude many analyses. CONCLUSIONS: Understanding suicidal behaviours and critical risk periods following discharge from residential treatment is crucial for improving continuing care, developing effective suicide prevention, and implementing targeted interventions among this high-risk population.

A systematic review of interventions that impact alcohol and other drug-related harms in licensed entertainment settings and outdoor music festivals.

BACKGROUND: Harms associated with the use of alcohol and other drugs (AOD) in licensed entertainment settings (LES) and outdoor music festivals (OMF) are ongoing public health and criminal justice concerns. This systematic review provides a comprehensive, synthesized report on the evidence base of interventions that impact harm in these settings, and how they affect health, behavioral, and criminal justice outcomes. METHODS: Nine databases were searched for experimental and observational studies published between 2010 and 2021. Studies were included if they were peer-reviewed, published in English, described interventions which could impact AOD-related harms in LES or OMF (and were delivered in these environments), and reported on health, criminal justice and/or behavioral outcomes. Methodological quality was assessed using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies and the Critical Appraisal Skills Program for qualitative studies. A narrative synthesis was conducted to synthesize outcomes across studies. The review protocol was registered in PROSPERO (CRD42020140004). RESULTS: Of the 48,303 studies screened, 100 met the inclusion criteria. 86 focused solely on reducing alcohol-related harm, 7 on reducing illicit drug-related harm, and 7 on both. Most (n = 88) focused on LES and evaluated changes in laws and regulations (n = 28) and/or multicomponent interventions/policies (n = 41). Multicomponent interventions showed the best results for both health (62% positive) and criminal justice (84% positive) outcomes, with 71% of studies being rated as strong quality. There was also good evidence to support the careful application of trading hour restrictions and limited but promising evidence to support medical services and drug checking. CONCLUSION: The breadth, quality and volume of evidence regarding what works in reducing AOD-related harm in recreational settings have increased in the past decade, particularly regarding LES. Findings support onsite medical services (reducing ambulance transfer rates), multicomponent interventions targeting alcohol accessibility and availability (reducing assaults), and drug checking services, but suggest other interventions such as drug detection dogs may exacerbate harm. Further, higher quality research is required to address identified gaps in the evidence base, particularly on optimal interventions within OMF, around illicit drugs more broadly and in the Global South.

The Impact of COVID-19 on Trends of Violence-Related Offences in Australia.

OBJECTIVE: To investigate the medium-term impacts of the COVID-19 pandemic on violence-related offences in Australia, and whether there was evidence of a 'dual pandemic' of family violence in addition to COVID-19. METHODS: Autoregressive Integrated Moving Average time series were conducted to analyse publicly available violent crime statistics data from January 2017 to November 2021. Population rates of homicide, sexual, domestic and non-domestic assault were assessed across each Australian state and territory, with the effects of COVID-19 being modelled using the average monthly World Health Organization COVID-19 stringency rating for each jurisdiction. FINDINGS: All jurisdictions in Australia showed increasing or stable domestic assault trends over the past decade, which were not significantly impacted by COVID-19, nor by the subsequent lockdowns. Non-domestic assaults demonstrated a significant, negative relationship with the stringency index for each jurisdiction, except Western Australia. There was no significant change in the rates of homicide or sexual assault across Australia in relation to COVID-19. CONCLUSION: Overall, there was no evidence of a 'dual pandemic' in Australia, and whilst domestic assaults continue to increase across the country, non-domestic assaults showed a notable but brief decline. However, these have returned to levels at least as high as pre-COVID-19 and some states show a continuing upward trend. The findings also suggest that alcohol availability may have played a role in continuing high violence numbers. Given the ongoing increasing and high levels of family violence in Australia, revised conceptual frameworks and interventions are indicated.

Impulsivity, masculine norms and patron pre-drinking levels in Queensland.

Pre-drinking is a common practice for young people prior to entering a night-time entertainment precinct (NEP), and is associated with numerous harms, such as increased experience of physical aggression and drink driving. The relationship between both impulsivity traits such as negative urgency, positive urgency and sensation seeking and conformity to masculine norms, and number of pre-drinks remains under-researched. The current study aims to explore whether level of negative urgency, positive urgency, sensation seeking, or conformity to masculine norms is associated with the number of pre-drinks consumed prior to entering a NEP. Participants included patrons aged under 30 years that were systematically selected for street surveys in Fortitude Valley and West End NEPs, Brisbane, Australia; and completed a follow-up survey in the week following (n = 312). Generalized structural equation modelling was used to fit five separate models with a negative binomial regression using a log link function, adjusting for age and sex. Postestimation tests were conducted to identify any indirect effects via an association between pre-drinking and enhancement motives. The standard errors were bootstrapped for the indirect effects. We found direct effects for sensation seeking. Indirect effects were present for Playboy norms, Winning norms, positive urgency and sensation seeking. While these findings provide some evidence that impulsivity traits can influence the number of pre-drinks an individual consumes, the findings suggest that some traits are more likely to be related to overall alcohol consumption and that pre-drinking is a unique type of alcohol consumption with distinct predictors that require further investigation.

Investigating the relationship between inaccurate blood alcohol concentration estimates, harm and other negative consequences.

INTRODUCTION: Alcohol-related harms place a significant burden on the Australian economy and health-care system. The current study aims to: (i) explore the relationship between blood alcohol concentration (BAC) and self-estimated blood alcohol concentration (EBAC); and (ii) determine whether BAC underestimation is related to an increased risk of experiencing physical aggression, verbal aggression, drink driving, ejection from a venue or refusal of service. METHODS: Patron street surveys were conducted in four night-time entertainment precincts (NEP) across Queensland, Australia, between June 2016 and November 2018. Participants (N = 2144) reported on their EBAC and recent negative or harmful experiences in NEPs. BAC was measured via a breathalyser. Paired samples t tests were conducted to determine if patrons' BAC and EBAC were significantly different. Logistic regressions were conducted to examine whether BAC underestimation is a significant predictor of harm and negative outcomes. RESULTS: Analyses identified a small, significant difference between patron's BAC and EBAC. Patrons with a low BAC were more likely to overestimate their BAC, while patrons with higher BACs were more likely to underestimate their BAC. Moderately intoxicated patrons had the most precise BAC estimations. Patrons with a high BAC and who underestimated their intoxication level were more likely to have been recently ejected from licensed venues, compared to accurate estimators or over-estimators. DISCUSSION AND CONCLUSIONS: Overall, patrons are poor evaluators of their own intoxication level, which may have implications for their experiences in NEPs. The findings highlight the need for improved BAC education for patrons.

Key informant perspectives on 3 am last drinks legislation in Queensland, Australia.

INTRODUCTION: The objective of this study was to explore key informant attitudes towards the 'Last Drinks at 3am' legislation in Safe Night Precincts in Queensland, Australia. METHOD: Sixty-six interviews were conducted with a range of stakeholders including licensees, law enforcement and frontline health professionals. Interviews were semi-structured and analysed using thematic analysis. Key informants responded to questions regarding their experiences of, and opinions about, the last drinks legislation. RESULTS: Key informants reported a range of experiences around the impact of last drinks restrictions, including reduced staffing costs and patron-related problems within licensed venues. While some venues reported that their businesses lost money, others reported no change in income or that they changed their business model to compensate. Law enforcement and health professionals reported a range of benefits including reduced alcohol-related anti-social behaviour, drunkenness and injury. CONCLUSIONS: The majority of key informants reported that the last drinks legislation reduced harm, while having minimal detrimental impact on business.

Factors Associated with Unwanted Sexual Attention in Australian Nightlife Districts: An Exploratory Study of Nightlife Attendees.

BACKGROUND: Experiences of unwanted sexual attention (UWSA) are commonplace within nightlife environments. While typically associated with aggression perpetration, literature has suggested that a history of childhood corporal punishment (CCP) may also be related to experiences of victimisation in nightlife environments. The current exploratory study aims to examine the associations between experiences of UWSA victimisation and a history of CCP, trait aggression, and conformity to masculine norms (Playboy and Winning), for males and females separately. METHOD: Street intercept interviews in the Brisbane inner-city entertainment precincts were used to measure demographic details and participants' breath alcohol concentration. Online follow-up surveys were used to record participants' experiences of UWSA on the night of interview, history of CCP, and self-reported rates of trait aggression and conformity to masculine norms. The final sample consisted of 288 females, as there were not sufficient male UWSA experiences for analysis. RESULTS: Approximately 20% of female nightlife patrons experienced some form of UWSA victimisation. Logistic regression analyses identified that after controlling for age and intoxication, a history of CCP, trait aggression and masculine norm conformity were unrelated to experiences of UWSA for female respondents. CONCLUSIONS: The current study found that individual factors were unrelated to experiences of UWSA, indicating that simply being in the nightlife environment, especially as a female, increases the risk of UWSA victimisation. Understanding and exploring social and environmental risk factors, rather than individual factors, is needed to prevent victimisation in nightlife environments.

Controlled Trial Examining the Strength-Based Grit Wellbeing and Self-Regulation Program for Young People in Residential Settings for Substance Use.

This cohort-controlled trial examined whether the 12-session Grit Wellbeing and Self-regulation Program enhanced the treatment outcomes of young people accessing residential alcohol and other drug (AOD) treatment. Grit focuses on increasing wellbeing and reducing substance use and mental health problems by building self-regulation skills, strengths, social connections, and health behaviours. Participants were 194 (66% male, Mage 27.40) young people (aged 18-35 years) accessing a six-week residential treatment program for substance use. Participants received standard treatment, or standard treatment plus Grit (two sessions/week for six weeks). The primary outcome was substance use, measured as: (i) global substance use and (ii) alcohol, methamphetamine, and cannabis use involvement. Secondary outcomes included wellbeing, depression, anxiety, and vocational engagement. Participants were assessed at baseline, and 6-weeks (secondary outcomes only), 3-months, 6-months, and 12-months post-program enrolment. Results revealed that both groups showed a significant improvement in all outcomes at three months, and improvements were maintained at 6- and 12-month follow-ups. The Grit group had a larger reduction in methamphetamine and cannabis use involvement compared to the control group. This study presents promising evidence that a six-week residential program can achieve improvements in AOD use, depression, anxiety, wellbeing and vocational engagement. Further, targeting self-regulation may enhance such programs.

Where to next? An exploration of 'night-out' location progression and propensity to experience violence in night -time entertainment precincts.

BACKGROUND: Alcohol related violence in night-time entertainment precincts (NEPs) is a significant public health concern. Studies suggest characteristics including venue density, bar hopping and permissive social norms facilitate violence in NEPs. Yet, we have a limited understanding of how individual drinking occasions progress within NEPs and how location sequence is associated with the propensity to experience violence in these spaces. METHODS: In this study we apply sequence analysis and logistic regression to examine the association between location sequences and experiences of violence among a sample of NEP patrons (N=387). RESULTS: We find that individuals who stay out longer and visit a greater number of unique location types are more likely to experience a violent event. We also find that attending a 'non-venue' pre-event such as a private party, gathering, sporting or celebratory event, is associated with elevated risk experiencing violence during a night out. CONCLUSION: The findings offer important insights into the dynamic context in which risky drinking occasions may emerge and suggest that the context and location in which pre-drinking occurs should be considered in future research.

The association of childhood physical abuse, masculinity, intoxication, trait aggression with victimization in nightlife districts.

BACKGROUND: High-risk intoxication, trait aggression and conformity to masculine norms are associated with increased risk of barroom aggression; however, less is understood regarding the factors associated with victimization in the night-time environment. OBJECTIVE: This study aimed to explore the influence of childhood physical abuse, high-risk intoxication, conformity to masculine norms and trait aggression on physical and/or verbal victimization in the night-time environment. PARTICIPANTS AND SETTING: A sample of N = 490 patrons aged 18-50 years (M = 23.02, SD = 5.89, 58.8% female) were recruited in Fortitude Valley and West End district, Queensland. METHOD: Participants completed a street interview, including breathalyser, and a follow-up online survey asking about experiences of aggression on the night of interview, experiences of childhood physical abuse and psychosocial correlates. RESULTS: For males, but not females, childhood physical abuse (OR = 3.98) increased the risk of physical and/or verbal victimization. Conformity to the masculine norm of Winning (OR = 0.21) was protective against physical and/or verbal victimization for males, and trait aggression (OR = 1.51) was significantly associated with increased risk of physical and/or verbal victimization for females. CONCLUSIONS: These findings add to the growing literature surrounding the long-term impacts of childhood physical abuse, demonstrating experiences of childhood physical abuse are significantly associated with victimization in the night-time economy. The current findings should be taken into consideration when constructing public policy or directed interventions, to help reduce aggression and violence in the night-time economy.

FullFix: a randomised controlled trial of a telephone delivered transdiagnostic intervention for comorbid substance and mental health problems in young people.

INTRODUCTION: Transdiagnostic cognitive-behavioural therapy (CBT) targets common psychological factors that underlie multiple disorders. While transdiagnostic interventions are a promising new approach, limited research has evaluated these treatments within the alcohol and other drug (AOD) sector for young people with comorbid mental health symptoms. This project will examine the feasibility and preliminary efficacy of FullFix-a new risk-targeted transdiagnostic CBT telehealth programme for comorbid AOD and depression/anxiety disorders in young people. Secondary aims are to identify moderators and mediators of treatment outcomes, to determine how and why treatment is effective and who is most likely to benefit. METHODS/DESIGN: Participants will be 130 young people (aged 16-35) accessing AOD services in Queensland, Australia, with comorbid mental health symptoms. They will be randomised to receive either the FullFix intervention plus standard AOD care or standard AOD care alone. Primary outcomes on AOD use and mental health symptoms will be reassessed at 6 weeks, 3 months, 6 months and 12 months, along with secondary outcomes of emotion regulation, social connectedness, perceived self-efficacy, coping skills and quality of life. The trial commenced on October 2018 and expected completion date is September 2021. ETHICS AND DISSEMINATION: Ethical approval for this trial was provided by the University of Queensland (#2018001185). The results of the trial will be disseminated through publication in a peer-reviewed scientific journal, scientific presentations at conferences and distributed via a report and presentations to the partner organisation. TRIAL REGISTRATION NUMBER: ACTRN12618001563257.

Utilising data linkage to describe and explore mortality among a retrospective cohort of individuals admitted to residential substance use treatment.

INTRODUCTION: Individuals with moderate to severe substance use disorders may seek residential treatment, but outcomes after discharge for this hard-to-reach population are often unknown. Using linked data, we examined mortality outcomes among individuals after residential treatment. METHODS: We included 1056 individuals admitted to three residential treatment facilities across Queensland, Australia, from 1 January 2014 to 31 December 2016. Records were linked to Queensland death registration data and cause of death records from the Australian Coordinating Registry (1 January-31 December 2018). Standard mortality ratios were assessed, comparing participants to the Queensland, Australia, general population. Causes of death and years of potential life lost (YPLL) were examined. RESULTS: Thirty-six participants died (3.4%) in 3408 years of follow-up data. The age- and sex-adjusted standard mortality ratios were 3.96 (95% confidence interval: 2.78, 5.48) overall, 8.19 (3.74, 15.55) in females and 3.38 (2.23, 4.92) in males. Two-thirds of deaths were due to suicide/overdose. There was an average of 45.50 YPLL (SD 9.16). DISCUSSION AND CONCLUSIONS: This study used linked data to quantify mortality following residential substance use treatment. The YPLL and avoidable nature of deaths highlight the need for continuing care following discharge from residential services.

Queensland Alcohol-related violence and Night-time Economy Monitoring (QUANTEM): Rationale and overview.

This commentary introduces the special section on the outcomes of the Queensland Alcohol-related violence and Night-time Economy Monitoring project and outlines the political and policy context of the interventions put in place under the Queensland government's Tackling Alcohol-Fuelled Violence strategy. The development of the strategy was informed by alcohol policy initiatives trialled in other major Australian cities over the past two decades. The articles in this special section examine the impact of the Tackling Alcohol-Fuelled Violence policy stages on alcohol-related harms and local economies across selected entertainment precincts (Safe Night Precincts). A rich array of data were utilised, including administrative health and justice data, data reflective of nightlife trading (i.e. foot traffic data, ID scanner data and live music performances) and street surveys. Findings have implications for research, policy and practice and demonstrate the need for comprehensive evaluations that can accommodate the complexities of modern alcohol policy in Australia.

The impact of Queensland's Tackling Alcohol-Fuelled Violence Policy on nightlife and business trade.

INTRODUCTION: Key elements of the Queensland Government's Tackling Alcohol Fuelled Violence (TAFV) policy included the introduction of mandatory identification (ID) scanners and reduced trading hours for licensed venues located within Safe Night Precincts (SNP). These measures raised concerns among licensed venue owners and other key stakeholders regarding the potential negative impact of the policy on business trade and nightlife. Using multiple data sources, this paper examines the impact of the TAFV policy on nightlife and trade in three Queensland SNPs: Fortitude Valley, Surfers Paradise and Cairns. METHODS: Data from ID scanners (2017-2019), foot traffic counters (2017-2019) and counts of liquor licences issued (2015-2019) were used to measure the policy's impact on the number of patrons and licensed venues within SNPs. Joinpoint regression and auto-regressive integrated moving average models were developed to examine changes in these measures over time. RESULTS: No significant changes were observed in the number of ID scans over time, although Surfers Paradise showed a 0.13% reduction during high alcohol hours. Foot traffic counts from Fortitude Valley showed no significant impact of the policy on the number of patrons in the area during high-alcohol hours. The number of commercial hotel licenses increased in all three regions, and commercial other-bar licenses increased in all regions except Surfers Paradise SNP where numbers remained stable. DISCUSSION AND CONCLUSIONS: Patterns in trading and the number of patrons within SNPs were mostly stable or increasing following the implementation of the TAFV policy beyond normal fluctuations.

The impact of liquor legislation changes on police-recorded serious assault in Queensland, Australia.

INTRODUCTION AND AIMS: In July 2016, the Queensland government introduced the Tackling Alcohol-Fuelled Violence policy, with some amendments over the subsequent 12 months. Key measures included restricting alcohol sales to 3 am in safe night precincts (SNPs), limiting the annual number of extended trading permits (i.e. trading until 5 am) and introducing mandatory networked identification scanners. We examined the policy impact on the number of serious assaults across all combined SNPs and in five major SNPs: Fortitude Valley, Cairns, Surfers Paradise, Toowoomba and Townsville. DESIGN AND METHODS: Using police data (July 2009-June 2019), we examined the impact of the policy on serious assaults during high-alcohol hours (high-alcohol hours; 8 pm-6 am, Friday and Saturday), employing time series methods. RESULTS: Across all SNPs there was no significant change in the number of serious assaults during overall high-alcohol hours, but a significant 49% decrease in the monthly number of serious assaults between 3 am and 6 am on Friday/Saturday. A significant decrease in the monthly count of serious assaults during high-alcohol hours and specifically 3 am-6 am on Friday/Saturday was evident in Fortitude Valley SNP (52%), and during high-alcohol hours in Toowoomba SNP (43%). DISCUSSION AND CONCLUSIONS: Although results were mixed, there was evidence of some promising reductions in alcohol-related violence in SNPs. It is likely that factors such as extended trading permits (venues not closing at 3 am), continued drinking in some venues and 24-h trading in casinos have reduced the potential impacts seen elsewhere.

The impact of changes to alcohol policy on patron drinking behaviours in Queensland.

INTRODUCTION: On 1 July 2016, stage 1 of the Tackling Alcohol-Fuelled Violence (TAFV) policy was introduced in Queensland, Australia and included restricted alcohol service to 03:00 in dedicated entertainment precincts (safe night precincts or SNPs). During stage 2 (from 1 February 2017), the number of extended trading permits (i.e. trading until 05:00) per venue were reduced; and during stage 3 (from 1 July 2017), networked identification scanners were mandated for late-night venues. We aim to examine whether patron drinking behaviours in two key SNPs changed significantly following stages 2 and 3. METHODS: The study design was repeated cross-sectional, with three data collection (policy) stages. Patrons street surveys were conducted in Fortitude Valley (n = 2066) and Cairns (n = 1021) SNPs between July 2016 and November 2018. Linear or negative binomial regressions were conducted to examine changes in three key outcomes: blood alcohol concentration (BAC) reading, proportion of pre-drinkers and number of pre-drinks. RESULTS: We found no significant difference in BAC reading, proportion of pre-drinkers or number of pre-drinks at stages 2 and 3 of the policy compared to baseline in Fortitude Valley. In Cairns, we found significant reductions in patron BAC at stage 3 of the policy, and female BAC at stages 2 and 3 compared to baseline; while the proportion of females pre-drinking significantly reduced by half in stage 2. DISCUSSION AND CONCLUSIONS: Despite evidence of some reductions in alcohol consumption, high levels of intoxication remain, suggesting harm reduction may be more difficult to achieve in these drinkers.

The impact of late-night alcohol restrictions on ambulance call-outs in entertainment precincts.

INTRODUCTION: In July 2016, the Queensland Government introduced the Tackling Alcohol-Fuelled Violence (TAFV) policy to address alcohol-related harm in entertainment precincts [safe night precincts (SNP)]. Additional measures were introduced in February and July 2017. We aim to examine the impact of the policy on Queensland Ambulance Service call-outs in Fortitude Valley, Surfers Paradise, all 15 SNP suburbs combined and statewide. METHODS: Auto-regressive integrated moving average (ARIMA) models and seasonal ARIMA (SARIMA) models were developed to test the impact of TAFV policy stages on monthly number of ambulance call-outs during high alcohol hours (HAH; Friday and Saturday nights, 20:00-05:59) over an 8-year period (July 2011-June 2019). RESULTS: The average number of monthly call-outs in HAH reduced by 26.2% in Fortitude Valley, 21.1% in Surfers Paradise and 4.3% in all 15 SNP suburbs combined. In Fortitude Valley, there was a significant decline in the monthly number of call-outs between 00:00 and 02:59 and across all HAH combined when examining the cumulative effect of the policy stages; and significant declines between 03:00 and 05:59 after each stage and cumulatively. Across the 15 SNP suburbs combined, there was a significant decline in call-outs between 03:00 and 05:59 after the third policy stage (July 2017). There were no significant declines in Surfers Paradise or statewide. DISCUSSION AND CONCLUSIONS: Overall, the introduction of the TAFV policy stages in Queensland had a limited effect on ambulance call-outs during HAH. However, there were some notable declines in HAH ambulance call-outs in some of the state's key nightlife suburbs.